A Work In Progress — The Experiment That Is My Life

smiley faceFor the first time in ages, I feel optimistic about a plan to get my health moving in the right direction again.  It seems like I’ve been spinning my wheels — even backsliding — since last summer.  After a visit with my doctor though, I’m confident that I have a workable plan, and I’m willing to share for those that are interested.

Some Background

I can’t remember a time in my life when I wasn’t fat.  I distinctly recall the first time that I came to that realization.  I was in the third grade, and I weighed 113 pounds.  By the time I was in the fifth grade, the reality of my obesity couldn’t have been made any clearer.  One of my classmates at the Indiana School for the Blind had somehow managed to lay hands on my size 14 jeans.  I’ll never forget how stunned she was when she asked in dismay, “Whose jeans are these? They’re the size of TEXAS!”

I knew my friend wasn’t trying to make fun of me.  She was just so shocked because not being able to see me, she didn’t realize that at 156 pounds, I probably weighed twice what she did.  My pants must have seemed almost surreal to her, and I’m guessing that she had a hard time wrapping her head around the idea that a “kid” could fit in them.

From around that time on, I tried a number of weight loss strategies.  In middle school, I tried “healthy” eating and exercise.  I tried the water diet (where I’d go for days without eating, but I’d drink enough water to make the hunger pains go away.) I ate a vegetarian diet for a year.  I even tried SlimFast.  Nothing seemed to work, and I just kept getting fatter.

It wasn’t until I was in college that I finally found something that “worked”.  I was fighting bulemia and I was spending two hours per day, six days a week at the gym.  At my lowest weight as an adult — 187 pounds — I was starting to look great, but I was so sick (mentally and physically.)  I remember going to the campus health clinic after a gallstone attack.  When I raised my shirt so the doctor could palpate my abdomen, she said, “Wow! Where did you get all these stretch marks?”

I wanted to burst into tears then and there, but I managed to stammer, “I’ve lost forty pounds.”  What I really wanted to say though was something along the lines of, “You don’t understand how badly I’ve treated myself to get here.  I’ve suffered, I’m still suffering, and it’s still not good enough? If you only knew, maybe you’d want to help me instead of judge me.”

It should come as no surprise, living the way I was, that my body eventually cried, “I give up!” A particularly awful gallbladder attack prompted a trip to the emergency room where I was told that my gallbladder was “full of stones” and I should be scheduled for surgery.  Having my gallbladder removed pretty much ended that crazy bit of my life, but as you can imagine, I gained back the weight I’d lost PLUS some.  I felt so hopeless.

It wasn’t until the middle of 1998 before I managed to get my head screwed on straight, and I decided to give low-carb eating another try.  I’d dabbled with it just before I had my gallbladder removed, but since I hadn’t read Dr. Atkins New Diet Revolution before getting started, I hadn’t really been “doing Atkins” back then.  I had decided though.  That time was gonna be different.  Finally, I was going to lose weight, I was going to do it in a healthy way, and I was going to keep that weight off.

So how’d that work for me? Well, at the ripe old age of 38, I weigh 250 pounds, I have diabetes and an underactive thyroid, and I’m currently taking more medications than I’d like.  So I guess what “they” say about low-carb eating must be true then; it doesn’t work and you’ll just end up sicker and fatter than when you started, right?

WRONG!!!!

Actually, I know that if I’d never heard of Dr. Atkins or Robb Wolf or Jimmy Moore or Dr. Bernstein or any of the hundreds of folks from whom I’ve learned so much about nutrition, I’d probably be dead right now.  Low-carb eating hasn’t failed me.  I’ve simply failed to put all the pieces together in a way that paints a picture of long-term success.  And despite what “they” would like you to believe, that’s an obstacle that hinders nearly all fat people.  If there’s something like a 95% chance that folks who lose weight won’t keep it off long-term, how can we attribute all that lack of success to one eating approach? That’s a discussion for  another day though.

For now, the most important thing you should take from my back story is that because of my life experiences, I’m the expert on Sarah.  And as the expert, although it might take time and the benefit of hindsight, I will find that perfect picture.  What’s more, I’ve only failed when I’ve stopped persevering.

I suppose that’s why I like and respect my current doctor so much.  As part of me persevering, I sought out a health care professional that understood the importance of low-carb eating as a basis on which to build a healthy lifestyle.  I also wanted someone who was compassionate, intelligent, and qualified.  Fortunately for me, I found all those things in my current provider.

The Problem

Since low-carb eating alone hadn’t been entirely managing my health conditions, I was open-minded when it came to trying some medications alongside my menu plan.  Some of those medications worked well, but other were what I’d call an “epic fail”.  I’ve struggled with a pretty significant drop in kidney function, severe hypoglycemia, and the symptoms of a down-regulated thyroid (which aren’t uncommon for some folks who eat a low-carb menu plan, but since I was already hypothyroid, it was pretty miserable.)

I also battled some fairly severe depression, and in the course of trying to treat it, I discovered that I’m allergic to a new, ridiculously expensive medication, and most other SSRIs caused some unacceptable side effects for me — things like intense confusion, lack of coordination, memory loss, and insomnia.  Needless to say, it’s been an interesting ride so far.

Right now, I find myself thinking back to my days in many a chemistry lab.  For this experiment that is my life now, I think the lab report would start something like this:

Purpose: To discover the mechanisms that will allow me to achieve (and maintain) certain indicators of health including:

  • fasting blood glucose of 75mg/dL – 85mg/dL
  • hemoglobin A1c of 5.0% – 5.3%
  • kidney function within “normal” laboratory range
  • blood pressure within “normal” range
  • weight in the “normal” range (for my frame and lean body mass)
  • TSH that’s stable at 2
  • vitamin D level of 60-70

while minimizing (or eliminating) adverse drug reactions and bothersome symptoms like:

  • allergic reactions
  • sleep disturbance
  • dehydration
  • IBS symptoms
  • orthostatic hypotension
  • severe depression
  • severe fatigue

My Plan

This experiment has actually been running for a while.  Every so often, I evaluate the data I’ve collected, and I ask myself, “Are we there yet?” Clearly, I haven’t yet discovered the “mechanisms” that’ll get me the results I want.  That’s OK though.  I still have loads of ideas!

The first part of my plan involves kicking a chronic sinus infection that I’ve been battling for months now.  As a last resort, I started an antibiotic along with an antifungal, and there’s been improvement there.  I find it hard to persevere when I feel awful, and this sinus thing has been kicking me down for a while now.

I also told my doctor that I wasn’t going to take Victoza for the time being.  I actually ran out in December, and I told him that looking back on everything I’ve faced, I can’t help but attribute a good deal of my issues to the Victoza.

See, I started Metformin, a blood pressure med, and a diuretic when I first started seeing Dr. Andry in March of 2013.  I had no issues.  Then in May, I started Victoza, and I started feeling horrible.  We backed off my Metformin, and I felt less horrible, but I still felt bad.

By June, I wasn’t feeling any better, and on my friend’s birthday, June 11, we found out why.  I collapsed in a pretty public way and was taken to the hospital by ambulance.  We discovered that my kidneys were in trouble.  Dr. Andry thought it the Metformin, and I thought it was the diuretic.  After stopping those though, I continued to get sicker.

It wasn’t until the end of 2013 that I realized (with the benefit of hindsight) that when I was less consistent about taking the Victoza, I felt better.  At that point though, it was just a theory, and I still thought I was just doomed to feel badly because of permanent kidney damage that I’d experienced earlier that year.

It didn’t hit me until I’d stopped the Victoza entirely though that it causing other issues for me as well.  Without the Victoza, I wasn’t experiencing severe hypoglycemia, and it was those episodes that were affecting almost every part of my life.  They were also making it darned near impossible for me to stay on track with low-carb eating (which also happened to compound the dehydration that Victoza was causing as well.)

I know, I know.  If you’ve made it this far, you’re probably wondering about my plan.

  1. Take the meds that should help me kick the sinus infection.
  2. Skip Victoza.
  3. Get back to a consistent low-carb eating plan.
  4. Prepare meals in advance to support my eating on plan.
  5. Get labs drawn to see if we need to make medication and supplement adjustments.
  6. Re-evaluate after one month.

As with all things, the “answers” aren’t immediately apparent.  Patience, perseverance, intelligence, and support have been crucial, and these attributes will continue to be vitally important to my long-term success.  What I do matters; I know that.  I also know that it’s up to me whether I play the role of victim or victor, and frankly, while walking the path to victory is rarely the easier path, the destination is its own reward.  I can do this!

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